Immunosuppressive drugs after simultaneous pancreas-kidney transplantation

J. Malaise, D. R J Kuypers, K. Claes, P. Evenepoel, B. Maes, W. Coosemans, J. Pirenne, Y. Vanrenterghem, D. Van Ophem, J. P. Squifflet, W. O. Bechstein, A. Kahl, J. Langrehr, I. Uhl, A. Engelking, P. Neuhaus, M. Stangl, W. D. Illner, A. Tarabichi, H. Schneeberger[No Value] Arbogast, W. Land, C. Dieterle, R. Landgraf, P. Boucek, M. Adamec, T. Havrdova, R. Koznarova, F. Saudek, W. Steurer, A. Königsrainer, R. Margreiter, [No Value] Mark, M. J. Ricart, L. Fernandez-Cruz, R. Nakache, R. Caldara, A. Secchi, D. Kuypers, Th Messiaen, J. Sandberg, G. Tyden, M. Mourad, T. Berney, P. Majno, C. Toso, L. Bühler, G. Mentha, N. De Carpentry, S. Demuylder-Mischler, P. Morel

Research output: Contribution to journalArticle

Abstract

Introduction. We report the early and late secondary effects of tacrolimus or cyclosporine-microemulsion (ME), in combination with mycophenolate mofetil (MMF), and rATG. Patients and methods. One hundred three patients were randomly assigned to tacrolimus (initial oral dose 0.2 mg/kg) and 102 to cyclosporine-ME (initial daily oral dose 7 mg/kg). All patients received 4 days of concomitant rATG induction therapy [ATG-Fresenius Biotech GmbH (ATG-F) daily dose of 4mg/kg or Thymoglobulin-Genzyme/Sangstat (Thymo-S) 1.25 mg/kg], MMF (2 to 3 g per day), and short-term corticosteroids. Results. Thymo-S was associated with a transiently lower white cell count in the first 3 months compared with ATG-F, while ATG-F caused a lower albeit transient early nadir in platelet count. Both polyclonal preparations were well tolerated; they did not differ with respect to clinically relevant side effects such as infections and malignancies. Higher cyclosporine-ME trough levels were associated with pancreas graft thrombosis. Study withdrawal was more frequent among patients on cyclosporine-ME therapy, because of toxicities, graft loss, and lack of efficacy, the last being the cause of subsequent switch to tacrolimus. Tacrolimus-treated patients were mainly withdrawn from the study due to MMF discontinuation. Conclusion. Short-term induction therapy in combined kidney-pancreas transplantation is effective and well tolerated. Tacrolimus causes fewer pancreas graft losses and fewer drug discontinuations due to side effects. When MMF is combined with tacrolimus, dose reductions and discontinuations are common.

Original languageEnglish
Pages (from-to)2840-2842
Number of pages3
JournalTransplantation Proceedings
Volume37
Issue number6
DOIs
Publication statusPublished - 2005

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Pancreas Transplantation
Tacrolimus
Immunosuppressive Agents
Kidney Transplantation
Mycophenolic Acid
Cyclosporine
Pharmaceutical Preparations
Transplants
Pancreas
Platelet Count
Adrenal Cortex Hormones
Thrombosis
Therapeutics
Cell Count
Infection
Neoplasms

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Malaise, J., Kuypers, D. R. J., Claes, K., Evenepoel, P., Maes, B., Coosemans, W., ... Morel, P. (2005). Immunosuppressive drugs after simultaneous pancreas-kidney transplantation. Transplantation Proceedings, 37(6), 2840-2842. https://doi.org/10.1016/j.transproceed.2005.05.022

Immunosuppressive drugs after simultaneous pancreas-kidney transplantation. / Malaise, J.; Kuypers, D. R J; Claes, K.; Evenepoel, P.; Maes, B.; Coosemans, W.; Pirenne, J.; Vanrenterghem, Y.; Van Ophem, D.; Squifflet, J. P.; Bechstein, W. O.; Kahl, A.; Langrehr, J.; Uhl, I.; Engelking, A.; Neuhaus, P.; Stangl, M.; Illner, W. D.; Tarabichi, A.; Schneeberger, H.; Arbogast, [No Value]; Land, W.; Dieterle, C.; Landgraf, R.; Boucek, P.; Adamec, M.; Havrdova, T.; Koznarova, R.; Saudek, F.; Steurer, W.; Königsrainer, A.; Margreiter, R.; Mark, [No Value]; Ricart, M. J.; Fernandez-Cruz, L.; Nakache, R.; Caldara, R.; Secchi, A.; Kuypers, D.; Messiaen, Th; Sandberg, J.; Tyden, G.; Mourad, M.; Berney, T.; Majno, P.; Toso, C.; Bühler, L.; Mentha, G.; De Carpentry, N.; Demuylder-Mischler, S.; Morel, P.

In: Transplantation Proceedings, Vol. 37, No. 6, 2005, p. 2840-2842.

Research output: Contribution to journalArticle

Malaise, J, Kuypers, DRJ, Claes, K, Evenepoel, P, Maes, B, Coosemans, W, Pirenne, J, Vanrenterghem, Y, Van Ophem, D, Squifflet, JP, Bechstein, WO, Kahl, A, Langrehr, J, Uhl, I, Engelking, A, Neuhaus, P, Stangl, M, Illner, WD, Tarabichi, A, Schneeberger, H, Arbogast, NV, Land, W, Dieterle, C, Landgraf, R, Boucek, P, Adamec, M, Havrdova, T, Koznarova, R, Saudek, F, Steurer, W, Königsrainer, A, Margreiter, R, Mark, NV, Ricart, MJ, Fernandez-Cruz, L, Nakache, R, Caldara, R, Secchi, A, Kuypers, D, Messiaen, T, Sandberg, J, Tyden, G, Mourad, M, Berney, T, Majno, P, Toso, C, Bühler, L, Mentha, G, De Carpentry, N, Demuylder-Mischler, S & Morel, P 2005, 'Immunosuppressive drugs after simultaneous pancreas-kidney transplantation', Transplantation Proceedings, vol. 37, no. 6, pp. 2840-2842. https://doi.org/10.1016/j.transproceed.2005.05.022
Malaise, J. ; Kuypers, D. R J ; Claes, K. ; Evenepoel, P. ; Maes, B. ; Coosemans, W. ; Pirenne, J. ; Vanrenterghem, Y. ; Van Ophem, D. ; Squifflet, J. P. ; Bechstein, W. O. ; Kahl, A. ; Langrehr, J. ; Uhl, I. ; Engelking, A. ; Neuhaus, P. ; Stangl, M. ; Illner, W. D. ; Tarabichi, A. ; Schneeberger, H. ; Arbogast, [No Value] ; Land, W. ; Dieterle, C. ; Landgraf, R. ; Boucek, P. ; Adamec, M. ; Havrdova, T. ; Koznarova, R. ; Saudek, F. ; Steurer, W. ; Königsrainer, A. ; Margreiter, R. ; Mark, [No Value] ; Ricart, M. J. ; Fernandez-Cruz, L. ; Nakache, R. ; Caldara, R. ; Secchi, A. ; Kuypers, D. ; Messiaen, Th ; Sandberg, J. ; Tyden, G. ; Mourad, M. ; Berney, T. ; Majno, P. ; Toso, C. ; Bühler, L. ; Mentha, G. ; De Carpentry, N. ; Demuylder-Mischler, S. ; Morel, P. / Immunosuppressive drugs after simultaneous pancreas-kidney transplantation. In: Transplantation Proceedings. 2005 ; Vol. 37, No. 6. pp. 2840-2842.
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abstract = "Introduction. We report the early and late secondary effects of tacrolimus or cyclosporine-microemulsion (ME), in combination with mycophenolate mofetil (MMF), and rATG. Patients and methods. One hundred three patients were randomly assigned to tacrolimus (initial oral dose 0.2 mg/kg) and 102 to cyclosporine-ME (initial daily oral dose 7 mg/kg). All patients received 4 days of concomitant rATG induction therapy [ATG-Fresenius Biotech GmbH (ATG-F) daily dose of 4mg/kg or Thymoglobulin-Genzyme/Sangstat (Thymo-S) 1.25 mg/kg], MMF (2 to 3 g per day), and short-term corticosteroids. Results. Thymo-S was associated with a transiently lower white cell count in the first 3 months compared with ATG-F, while ATG-F caused a lower albeit transient early nadir in platelet count. Both polyclonal preparations were well tolerated; they did not differ with respect to clinically relevant side effects such as infections and malignancies. Higher cyclosporine-ME trough levels were associated with pancreas graft thrombosis. Study withdrawal was more frequent among patients on cyclosporine-ME therapy, because of toxicities, graft loss, and lack of efficacy, the last being the cause of subsequent switch to tacrolimus. Tacrolimus-treated patients were mainly withdrawn from the study due to MMF discontinuation. Conclusion. Short-term induction therapy in combined kidney-pancreas transplantation is effective and well tolerated. Tacrolimus causes fewer pancreas graft losses and fewer drug discontinuations due to side effects. When MMF is combined with tacrolimus, dose reductions and discontinuations are common.",
author = "J. Malaise and Kuypers, {D. R J} and K. Claes and P. Evenepoel and B. Maes and W. Coosemans and J. Pirenne and Y. Vanrenterghem and {Van Ophem}, D. and Squifflet, {J. P.} and Bechstein, {W. O.} and A. Kahl and J. Langrehr and I. Uhl and A. Engelking and P. Neuhaus and M. Stangl and Illner, {W. D.} and A. Tarabichi and H. Schneeberger and Arbogast, {[No Value]} and W. Land and C. Dieterle and R. Landgraf and P. Boucek and M. Adamec and T. Havrdova and R. Koznarova and F. Saudek and W. Steurer and A. K{\"o}nigsrainer and R. Margreiter and Mark, {[No Value]} and Ricart, {M. J.} and L. Fernandez-Cruz and R. Nakache and R. Caldara and A. Secchi and D. Kuypers and Th Messiaen and J. Sandberg and G. Tyden and M. Mourad and T. Berney and P. Majno and C. Toso and L. B{\"u}hler and G. Mentha and {De Carpentry}, N. and S. Demuylder-Mischler and P. Morel",
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TY - JOUR

T1 - Immunosuppressive drugs after simultaneous pancreas-kidney transplantation

AU - Malaise, J.

AU - Kuypers, D. R J

AU - Claes, K.

AU - Evenepoel, P.

AU - Maes, B.

AU - Coosemans, W.

AU - Pirenne, J.

AU - Vanrenterghem, Y.

AU - Van Ophem, D.

AU - Squifflet, J. P.

AU - Bechstein, W. O.

AU - Kahl, A.

AU - Langrehr, J.

AU - Uhl, I.

AU - Engelking, A.

AU - Neuhaus, P.

AU - Stangl, M.

AU - Illner, W. D.

AU - Tarabichi, A.

AU - Schneeberger, H.

AU - Arbogast, [No Value]

AU - Land, W.

AU - Dieterle, C.

AU - Landgraf, R.

AU - Boucek, P.

AU - Adamec, M.

AU - Havrdova, T.

AU - Koznarova, R.

AU - Saudek, F.

AU - Steurer, W.

AU - Königsrainer, A.

AU - Margreiter, R.

AU - Mark, [No Value]

AU - Ricart, M. J.

AU - Fernandez-Cruz, L.

AU - Nakache, R.

AU - Caldara, R.

AU - Secchi, A.

AU - Kuypers, D.

AU - Messiaen, Th

AU - Sandberg, J.

AU - Tyden, G.

AU - Mourad, M.

AU - Berney, T.

AU - Majno, P.

AU - Toso, C.

AU - Bühler, L.

AU - Mentha, G.

AU - De Carpentry, N.

AU - Demuylder-Mischler, S.

AU - Morel, P.

PY - 2005

Y1 - 2005

N2 - Introduction. We report the early and late secondary effects of tacrolimus or cyclosporine-microemulsion (ME), in combination with mycophenolate mofetil (MMF), and rATG. Patients and methods. One hundred three patients were randomly assigned to tacrolimus (initial oral dose 0.2 mg/kg) and 102 to cyclosporine-ME (initial daily oral dose 7 mg/kg). All patients received 4 days of concomitant rATG induction therapy [ATG-Fresenius Biotech GmbH (ATG-F) daily dose of 4mg/kg or Thymoglobulin-Genzyme/Sangstat (Thymo-S) 1.25 mg/kg], MMF (2 to 3 g per day), and short-term corticosteroids. Results. Thymo-S was associated with a transiently lower white cell count in the first 3 months compared with ATG-F, while ATG-F caused a lower albeit transient early nadir in platelet count. Both polyclonal preparations were well tolerated; they did not differ with respect to clinically relevant side effects such as infections and malignancies. Higher cyclosporine-ME trough levels were associated with pancreas graft thrombosis. Study withdrawal was more frequent among patients on cyclosporine-ME therapy, because of toxicities, graft loss, and lack of efficacy, the last being the cause of subsequent switch to tacrolimus. Tacrolimus-treated patients were mainly withdrawn from the study due to MMF discontinuation. Conclusion. Short-term induction therapy in combined kidney-pancreas transplantation is effective and well tolerated. Tacrolimus causes fewer pancreas graft losses and fewer drug discontinuations due to side effects. When MMF is combined with tacrolimus, dose reductions and discontinuations are common.

AB - Introduction. We report the early and late secondary effects of tacrolimus or cyclosporine-microemulsion (ME), in combination with mycophenolate mofetil (MMF), and rATG. Patients and methods. One hundred three patients were randomly assigned to tacrolimus (initial oral dose 0.2 mg/kg) and 102 to cyclosporine-ME (initial daily oral dose 7 mg/kg). All patients received 4 days of concomitant rATG induction therapy [ATG-Fresenius Biotech GmbH (ATG-F) daily dose of 4mg/kg or Thymoglobulin-Genzyme/Sangstat (Thymo-S) 1.25 mg/kg], MMF (2 to 3 g per day), and short-term corticosteroids. Results. Thymo-S was associated with a transiently lower white cell count in the first 3 months compared with ATG-F, while ATG-F caused a lower albeit transient early nadir in platelet count. Both polyclonal preparations were well tolerated; they did not differ with respect to clinically relevant side effects such as infections and malignancies. Higher cyclosporine-ME trough levels were associated with pancreas graft thrombosis. Study withdrawal was more frequent among patients on cyclosporine-ME therapy, because of toxicities, graft loss, and lack of efficacy, the last being the cause of subsequent switch to tacrolimus. Tacrolimus-treated patients were mainly withdrawn from the study due to MMF discontinuation. Conclusion. Short-term induction therapy in combined kidney-pancreas transplantation is effective and well tolerated. Tacrolimus causes fewer pancreas graft losses and fewer drug discontinuations due to side effects. When MMF is combined with tacrolimus, dose reductions and discontinuations are common.

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JO - Transplantation Proceedings

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